Anaesthesia and Intensive Care最新文献_第3页

Shoulder tip pain during and after caesarean section: A narrative review. 剖宫产术中和剖宫产术后肩尖疼痛：一项叙述性回顾。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-09 DOI: 10.1177/0310057X261478643

Yu-Jen Chen, Patrick Cf Tan

引用次数: 0

Effects of spiral deflation and warming on cuff diameter, insertion force, extubation, and sealing performance in polyvinyl chloride-cuffed tracheal tubes. 螺旋放气和加热对聚氯乙烯套管袖口直径、插入力、拔管和密封性能的影响。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-09 DOI: 10.1177/0310057X261478645

Hiroki Yonezawa, Michiko Kinoshita, Chiaki Murakami, Takako Ikezaki, Katsuya Tanaka

{"title":"Effects of spiral deflation and warming on cuff diameter, insertion force, extubation, and sealing performance in polyvinyl chloride-cuffed tracheal tubes.","authors":"Hiroki Yonezawa, Michiko Kinoshita, Chiaki Murakami, Takako Ikezaki, Katsuya Tanaka","doi":"10.1177/0310057X261478645","DOIUrl":"https://doi.org/10.1177/0310057X261478645","url":null,"abstract":"Cuffed tracheal tubes are widely used in paediatric airway management, but passage through the relatively narrow subglottic airway may increase insertion resistance and risk mucosal trauma. This study evaluated whether spiral deflation (i.e. folding the cuff inward like an umbrella) and warming the tube could reduce cuff diameter and insertion force in a simulated trachea. Four commercially available polyvinyl chloride-cuffed tubes with an internal diameter of 5.0 mm (PORTEX® (Smiths Medical International Ltd, Ashford, UK), Sheridan® (Teleflex Inc., Morrisville, NC, USA), Shiley™ (Medtronic, Minneapolis, MN, USA), and VentiSeal™ (Flexicare Medical Ltd, Mountain Ash, UK)) were examined. Spiral deflation significantly reduced cuff diameter, with reductions of (mean difference, MD) -3.6 mm (95% confidence intervals, CI -4.5 to -2.7, P <0.001), -2.8 mm (-4.0 to -1.6, P <0.001), -3.5 mm (-5.0 to -2.1, P=0.001), and -4.9 mm (-6.0 to -3.9, P <0.001), respectively. Spiral deflation also decreased insertion force, with reductions of (MD (CI)) -1.01 N (-1.52 to -0.50, P=0.008), -0.34 N (-0.63 to -0.05, P=0.115), -0.49 N (-0.61 to -0.37, P <0.001), and -2.33 N (-3.83 to -0.84, P=0.028), respectively. Additional warming at 40°C further lowered insertion force, with reductions of (MD (CI)) -0.12 N (-0.19 to -0.05, P=0.020), -0.06 N (-0.08 to -0.03, P=0.002), -0.07 N (-0.11 to -0.03, P=0.010), and -0.48 N (-0.86 to -0.11, P=0.068), respectively. Spiral deflation with warming did not affect extubation force or sealing performance. Overall, spiral deflation effectively reduced cuff diameter by approximately 25% and lowered insertion force, while warming further enhanced ease of insertion. These approaches did not compromise sealing or extubation performance.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X261478645"},"PeriodicalIF":1.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is jelly a solid or a clear liquid? A pilot study using ultrasound to assess the gastric emptying of fruit-flavoured gelatin dessert. 果冻是固体还是透明液体？一项利用超声波评估水果味明胶甜点胃排空的初步研究。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-01 Epub Date: 2026-06-14 DOI: 10.1177/0310057X261442555

Anthony D Hade, Kate Morgan, Stacey Llewellyn, Fraser Ja Morton

{"title":"Is jelly a solid or a clear liquid? A pilot study using ultrasound to assess the gastric emptying of fruit-flavoured gelatin dessert.","authors":"Anthony D Hade, Kate Morgan, Stacey Llewellyn, Fraser Ja Morton","doi":"10.1177/0310057X261442555","DOIUrl":"10.1177/0310057X261442555","url":null,"abstract":"Pre-anaesthesia fasting guidelines typically recommend a six-hour fast for solids and a two-hour fast for clear liquids. Jelly is a fruit-flavoured gelatin dessert that exists as a viscoelastic semi-solid mass when refrigerated but melts back into its liquid form once ingested; therefore, it is not obvious to which category it should belong. We used ultrasound to investigate gastric emptying following ingestion of jelly in a pilot study of 10 fasted healthy adult volunteers. First, a baseline scan was performed to confirm their estimated gastric volume was less than 2.3 ml/kg (the 95th centile for a fasted population). Subjects then ate 400 g of jelly and underwent repeated scans every 10 minutes until their estimated gastric volume had returned to baseline. Median (interquartile range) estimated gastric volume was 0 (0-0.6) ml/kg at baseline, peaked at 3.1 (2.7-4.3) ml/kg 10 minutes post-ingestion and had decreased to 0 (0-0.9) ml/kg by two hours. It took a median (interquartile range) of 70 (47.5-80.0) minutes for estimated gastric volume to fall below 2.3 ml/kg, and 110 (110-130) minutes before it had returned to baseline. These data suggest that, for serving sizes up to 400 grams of jelly there might be no justification for mandating a six-hour fast prior to anaesthesia.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"469-475"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The evolution of anticoagulants for the prevention and treatment of deep vein thrombosis. 预防和治疗深静脉血栓的抗凝剂的发展。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-01 Epub Date: 2026-09-16 DOI: 10.1177/0310057X261474522

Christine M Ball, Peter J Featherstone

引用次数: 0

Large language model prompt engineering for medical education: A practical guide for the Australian and New Zealand College of Anaesthetists Final Examination. 大型语言模型提示工程医学教育：澳大利亚和新西兰麻醉师学院期末考试实用指南。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-01 Epub Date: 2026-06-14 DOI: 10.1177/0310057X261453395

Timothy J Trewren, Galina Gheihman, Kelly Bratkovic, D-Yin Lin, Stewart Anderson, Dario Winterton, Christina Gao, Brandon Stretton

{"title":"Large language model prompt engineering for medical education: A practical guide for the Australian and New Zealand College of Anaesthetists Final Examination.","authors":"Timothy J Trewren, Galina Gheihman, Kelly Bratkovic, D-Yin Lin, Stewart Anderson, Dario Winterton, Christina Gao, Brandon Stretton","doi":"10.1177/0310057X261453395","DOIUrl":"10.1177/0310057X261453395","url":null,"abstract":"Large language models (LLMs) can achieve passing scores in specialist-level examinations, yet their capacity to author high-stakes examination content remains under-explored. Compared with published human benchmarks, LLMs create questions roughly 10 times faster, and contextual memory across sessions enables rapid diversification of topic coverage. Prompt design therefore emerges as an academic, not merely technical, craft. This article synthesises the emerging literature on artificial intelligence-assisted item writing and illustrates, through stepwise experimentation with OpenAI GPT-4o, how deliberate prompt engineering can align LLM output with the high standards of medical examinations. Key strategies explored include defining clinical context, imposing structural constraints, supplying exemplar items, assigning examiner roles, sequencing chain-of-thought instructions and requesting rationales. In a worked example, these approaches are layered sequentially while generating short-answer questions mapped to Australian and New Zealand College of Anaesthetists curriculum statements. An evidence-based approach to LLM use for question generation could markedly reduce examiner workload, provide educational integrity and enrich item banks.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"476-479"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ultrasound phantoms for regional anaesthesia: a survey of acceptability and realism. 区域麻醉的超声幻象：可接受性和真实性的调查。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-01 Epub Date: 2026-06-14 DOI: 10.1177/0310057X261442980

Kelly Byrne, Jerome Byrne

引用次数: 0

Evaluating the completeness of perioperative outcome metrics in electronic medical records: Insights based on the proposed Perioperative Clinical Outcomes Registry framework. 评估电子病历中围手术期结局指标的完整性：基于拟议的围手术期临床结局注册框架的见解

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-01 Epub Date: 2026-06-14 DOI: 10.1177/0310057X261454389

Andrew J Inglis, Jan M Dieleman

{"title":"Evaluating the completeness of perioperative outcome metrics in electronic medical records: Insights based on the proposed Perioperative Clinical Outcomes Registry framework.","authors":"Andrew J Inglis, Jan M Dieleman","doi":"10.1177/0310057X261454389","DOIUrl":"10.1177/0310057X261454389","url":null,"abstract":"Electronic medical records (eMRs) could support perioperative outcomes registries, but the completeness of routinely collected data remains uncertain. This study evaluated the availability of perioperative data within a large Australian hospital eMR against the Perioperative Clinical Outcomes Registry Extended (PCOREx) dataset. A retrospective audit of all elective inpatient procedures involving anaesthetists at Westmead Hospital (Sydney, New South Wales) in June 2022 was performed. Records were reviewed in Cerner® PowerChart (Cerner Corporation, Kansas City, MO, USA) and completeness was defined as the presence of PCOREx variables across Baseline Risk, Intraoperative Risk, Process of Care, In-Hospital Outcomes and Post-Discharge Outcomes. A total of 405 patients met inclusion criteria. Overall completeness was 63%; excluding post-discharge variables, inpatient completeness was 77.5%. Demographic, procedural and intraoperative physiological data-mostly structured or automatically captured-were consistently recorded (>90%). Comorbidities, frailty indices, intraoperative temperature, and fluid balance were less complete (<50%). Post-discharge outcomes were recorded in only 7.9% of patients, limited to those who re-presented to hospital. Missingness reflected both structural gaps (absence of fields, siloed intensive care unit systems) and clinical behaviour (selective documentation, variable pathology ordering). While routine eMR data capture many perioperative variables, significant gaps remain, particularly for post-discharge outcomes and selectively documented fields. Mapping completeness within the Clinical Adoption Meta Model framework highlights barriers at system and clinical levels. Standardised data capture, linkage with external databases, and improved interoperability are needed to realise the potential of eMRs for perioperative outcomes registries.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"453-463"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics and outcomes of intensive care patients receiving metaraminol infusion-a retrospective observational cohort study. 重症监护患者输注甲氨醇的特点和结局——一项回顾性观察队列研究。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-01 Epub Date: 2026-07-10 DOI: 10.1177/0310057X261453973

Rahul Costa-Pinto, Ary Serpa Neto, Andrew Udy, Linda Nguyen, Glenn Eastwood, Stephen Warrillow, Daryl Jones

{"title":"Characteristics and outcomes of intensive care patients receiving metaraminol infusion-a retrospective observational cohort study.","authors":"Rahul Costa-Pinto, Ary Serpa Neto, Andrew Udy, Linda Nguyen, Glenn Eastwood, Stephen Warrillow, Daryl Jones","doi":"10.1177/0310057X261453973","DOIUrl":"10.1177/0310057X261453973","url":null,"abstract":"There is limited published data on metaraminol dosing, duration of therapy and clinical outcomes for critically ill patients. We conducted a retrospective cohort study across two tertiary intensive care units (ICUs) and included all patients who received a metaraminol infusion between 26 August 2016 and 31 December 2021. The primary outcome of this study was to describe the characteristics and outcomes of patients who receive metaraminol in ICU. Secondary outcomes included a range of pharmacological and physiological measures. We studied 1261 patients, which represented 6.7% of ICU admissions during the study period. Most (85.4%) patients were unplanned admissions and less than 40% required mechanical ventilation. ICU and hospital mortality were low (7.4% and 12.4% respectively). Median total infusion duration for metaraminol was 10 (interquartile range, 3-24) h. Median dose range was 1 mg/h (16 µg/min) to 6 mg/h (100 µg/min). Almost three-fifths of these patients subsequently transitioned to norepinephrine (noradrenaline), which commenced at a median time of 7 h after initiation of metaraminol. Hourly heart rate, mean arterial pressure and respiratory rate remained very stable during infusion of metaraminol and median urine output remained greater than 30 ml/h for the first 24 h. In conclusion, patients who received metaraminol by infusion in the ICU had a low severity of illness and risk of mortality. Dosing of metaraminol was conservative and clinicians frequently transitioned to norepinephrine early despite the low doses infused. Metaraminol effectively maintained blood pressure with no associated tachycardia or significant drop in urine output and no clinical evidence of tachyphylaxis.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"431-437"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pharmaceutical industry payments to Australian anaesthetists and pain medicine specialists: 2015-2024. 制药行业对澳大利亚麻醉师和止痛药专家的支付：2015-2024。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-01 Epub Date: 2026-07-26 DOI: 10.1177/0310057X261454713

Steven C Cai, Anne-Marie Amie W Dempster, Malcolm Forbes

引用次数: 0

Complications related to arterial line catheters and monitoring reported to webAIRS, 2009-2023. 2009-2023年webAIRS报道动脉导管相关并发症及监护。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-01 Epub Date: 2026-06-14 DOI: 10.1177/0310057X261450643

Victoria M Tsang, Martin D Culwick, Victoria A Eley

{"title":"Complications related to arterial line catheters and monitoring reported to webAIRS, 2009-2023.","authors":"Victoria M Tsang, Martin D Culwick, Victoria A Eley","doi":"10.1177/0310057X261450643","DOIUrl":"10.1177/0310057X261450643","url":null,"abstract":"Arterial catheters are commonly inserted for intraoperative monitoring but are known to cause complications. We analysed all cases of arterial catheter complications and incidents related to arterial line monitoring reported to webAIRS. Anaesthetists voluntarily reported cases between 2009 and 2023. Included incidents met keyword search criteria and involved the insertion and presence of an arterial catheter, covering complications relating to the accuracy of arterial blood pressure readings, equipment or monitoring malfunction or human error related to equipment usage. Our aim was to promote awareness of both common and rare complications of arterial lines. Of the 10,518 incidents, 53 incidents met criteria, with 54 events described. Twenty-seven (50%) incidents were related to equipment failure, 17 (31%) compromised flow, five (9%) nerve injury, two (4%) medication error, one (2%) injury to skin, one (2%) infection and one (2%) inability to place an arterial catheter. The most common equipment problem was related to inappropriate transducer height causing inaccurate readings. No harm occurred in 16 (29.5%) of the patients, mild harm in 25 (46%), moderate harm in 10 (18.5%), severe harm in two (4%) and death in one (2%). Clinician vigilance is critical in the preparation, insertion and monitoring of arterial catheters, to allow the detection of problems and prevention of patient harm.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"438-444"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0